Health Canada approved on Monday the first oral COVID-19 medication that can prevent severe illness or death in some high-risk individuals, an important milestone that could eventually help alleviate some pressure on hospitals.
Paxlovid, an oral antiviral pill manufactured by Pfizer, is a combination of two medications, nirmatrelvir and ritonavir, and works by stopping the virus from replicating. But given global supply limits, Canada’s Chief Public Health Officer Theresa Tam said the drug “won’t be a key contributor” in efforts to counter the Omicron wave.
Federal Minister of Public Services and Procurement Filomena Tassi said Monday that Canada has received an initial shipment of 30,400 treatment courses, with another 120,000 expected before the end of March. Ontario said on Monday it expects 10,000 doses of the medication this month and that the drug will initially be available at 15 hospitals across the province.
Isaac Bogoch, an infectious-diseases physician at Toronto’s University Health Network, said the drug will likely be most beneficial over the long term to help prevent severe illness in some and keep more people out of hospital.
“COVID’s not going anywhere any time soon and it’s still phenomenal to at least have the first step forward having this [drug] out in the community where it will do good,” Dr. Bogoch said.
Health Canada approved the drug for treatment in people who have a confirmed COVID-19 infection and have a high risk of developing severe illness requiring hospitalization, such as older Canadians who are unvaccinated or whose vaccinations are not up to date, and people with immune-compromising conditions.
Data released by Pfizer show the drug can dramatically reduce the chances of hospitalization and death in high-risk individuals. Dr. Bogoch cautioned that more research needs to be done to have a full understanding of how well the drug works in a variety of people.
Dr. Tam said the highest risk categories for Paxlovid prioritization at the outset include immunocompromised individuals, people 80 and older and people 60 and older living in remote or rural communities, living in long-term care or those from First Nations, Métis or Inuit communities whose vaccinations aren’t up to date.
Federal officials also emphasized the need to ensure good access to Paxlovid in remote and rural communities where there is less access to tertiary care centres, which handle complex patients.
The drug must be taken within five days of symptom onset, which presents a series of logistical and practical challenges. Individuals will need to see a health care provider, obtain a COVID-19 test and wait for results before getting a prescription, which can be difficult to accomplish over the course of a few days.
Dr. Tam said in a briefing Monday that some clinicians, such as those who treat people with immune-compromising health conditions, can start preparing plans for fast and efficient prescribing of Paxlovid, which could help ensure it reaches those high-risk patients in a timely manner. Pharmacies could play an important role because they are located throughout the community and don’t require an appointment.
Dr. Bogoch said he hopes officials allow the drug to be distributed from a variety of channels, including pharmacies, to help ensure it can be given to people in a timely and efficient way.
Paxlovid interacts with a number of common medications, including blood thinners, drugs used to treat seasonal allergies and treatments for some heart conditions, which means some high-risk individuals may not be able to take it.
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